Vyshnevska O. Long-term hGH therapy in children and adolescents with GH deficiency^ influence on auxologic: hormonal and biochemical parametrs

Object of the study: growth hormone deficiency (GHD) in children of pubertal age. Aim of the study: to improve and increase the efficacy of diagnosis and treatment of growth hormone deficiency in children based on a study of the dynamics of auxological, biochemical and hormonal indices. Methods of investigation and equipment: epidemiological, clinical, biochemical, instrumental, statistical methods; analyzer “BC 3000 Plus”, stadiometer “System Dr. Keller J.”, photometer “Biosystems” (BTS-330), ultrasound device “TOSHIBA”. Theoretical and practical results: the study of hormonal and biochemical indices allowed to recommend testing of the levels of insulin-like growth factor-1 (IGF-1), IGF-binding protein-3 (IGF-3B-3), alkaline phosphatase as criteria for assessing the effectiveness of a long-term therapy of growth hormone deficiency in children using preparations of recombinant growth hormone (rGR). The effect of long-term rGR therapy on the status of pituitary-thyroid and pituitary-adrenal systems has been assessed. The study has proven the need for a continuous monitoring of blood levels of thyroid hormones and cortisol in patients with GHD during long-term rGR therapy, and for a timely administration of replacement therapy with L-thyroxine and glucocorticoids, which optimizes the treatment of children with GHD. Novelty: this combined study has identified a decreased thyroid function and decreased cortisol concentrations in the presence of a prolonged use of rGR in children with growth hormone deficiency, which is a scientific justification for a mandatory monitoring of thyroid hormones and cortisol levels and timely administration of replacement therapy. In the presence of a long-term treatment with rGR, a significant increase in the following indicators has been demonstrated: (IGF-1) (IGF-3B-3), and alkaline phosphatase. Degree of introduction: the results of investigation are introduced into the practice of children’s hospitals in Ukraine and into the teaching process at the Department of Endocrinology of P.L. Shupyk National Academy of Postgraduate Education. Field of application: endocrinology, pediatrics.